one couple, two cats, thousands of miles, the journey through infertility, a high risk pregnancy, and finally, a baby girl

Friday, August 26, 2011

10 weeks, second U.S. appointment

I saw my high risk OB on Monday, and haven’t updated the blog, because I wasn’t sure what to share, how much to share, etc, until some decisions had been made. Since several days have passed and nothing has been decided, here is an update, and if you feel so inclined to offer a suggestion, I’d love to hear/ read it.

First, a few highlights from the visit. I got a big hug and very warm welcome back. I just feel so comfortable with this clinic. They are all wonderful, from the receptionists to the nurses to the doctors to the lab techs. Just great, great people.

So, my doctor said that the chance of a c-section goes way up with a twin pregnancy, so to prepare for that. I told her that I was prepared for a c-section last year and look how that turned out, so this time I might take a Lamaze class instead ;) She did an ultrasound in the office (sorry, no pictures were printed). Both babies looked great. Baby A was sleeping. Baby B was dancing all over the place as usual, leading to a discussion about their genders. So far, the general consensus has been one girl and one boy. My doctor agreed, for the sole reason that Baby B was so active. It will be interesting to find out if everyone is correct.

Okay, onto the bad news….

My doctor doesn’t want me to travel, specifically, outside of the U.S. Not only do I have all of the high risk issues I had during my pregnancy with Kate, but now I have all of the risks and potential issues that come with a twin pregnancy. To add even more fun to the mix, they also found that I have a Factor V Leiden mutation, which is honestly not a big deal, since I’m already on the recommended treatment (heparin and baby aspirin) for one of the autoimmune issues. My doctor is most concerned about premature rupture of membranes, cervical shortening, preterm labor, and also the ethical issues of whether a 20, 22 week pregnancy would even try to be saved in certain countries (most likely not). At least here, she would do her best to get the babies to viability, so they’d have a chance at survival.

She went on to say that if this were a fourth baby and I had no history of preterm labor, she’d have no problem with me traveling and returning to the U.S. within a reasonable timeframe. While I was getting dressed after the appointment, she consulted with a colleague, who completely agreed with her, particularly since it’s an IVF pregnancy. We’ve worked too hard to take risks, seems to be the standard opinion.

As of now, I’m scheduled for the nuchal scan and to meet with a genetic counselor on Monday. They’ve also scheduled an appointment with yet another perinatologist in a few weeks. Of course the earliest he could see me was the day after I’m supposed to fly from DC to Slovakia.

Needless to say, I haven’t been getting much sleep, stress is at an all time high and I honestly don’t know what to do.

6 comments:

Oh dear, I completely understand it's quite stressful (I know you are in perfect hands so I'm not worried), if you stay, Kate will not get to see her dad much at least till the twins arrive. Maybe you could see if they let you travel and be back say within a month or two at the most and than stay put till the big arrival. Cervical issues are unlikely to happen at least till 16-18 weeks even with twins I think and you didn't have it with Kate. but of course, there's the family unity that matter also. It's a very difficult decision. What does your husband say?Love, Fran

Sounds like your dr's are all concerned for you and the babies. I agree with Fran, see if you can travel for a short period of time and return. I'm sure it's hard for you and Kate to be away from your hubby. Can your husband travel here to visit??

Sorry it's so stressful right now. I hope you can relax a little, for the babies sake (I know, easier said than done!).

Oh dear. What a difficult decision with which to be faced. I am sorry you are having to make this decision. It sounds like they really don't like the sound of you traveling at all. I don't know what I would do if I were in yout situation. On one hand I generally listen to and follow the advice of doctors I trust. But on the other hand, I cannot imagine going that long without seeing my husband. I willbe praying that God will make the decision blaringly obvious to you.

Having dealt with a twin pregnancy that became high-risk with preterm labor, almost a very early delivery, months of bedrest, here's my suggestion.

If I were you and planning to deliver in Slovakia, I'd get on the plane soon and stay put. But if I were going to go and come back, I think I'd skip the trip and stay in the U.S., and hope that my husband could come and visit a couple of times (and that the relatives in the U.S. could help A LOT with Kate).

Wow. That's tough. I'd probably talk to MED about it (at the risk that they pull your medical clearance, and make the decision for you), or talk to the health practitioner at post about what the realities are in the case of very premature babies. But in the end, I'd probably go until about 20 weeks (unfortunately, not much can be done if something bad happens before that) and then return to the U.S. for weeks 20-40, or however long you can go -- unless, as someone above said, you decide to deliver in Slovakia, in which case, I'd just go now. Good luck! And congratulations again! Sounds like everything is going great so far.

I'm not terribly concerned about the separation. It's part of the foreign service and something that my husband was aware of, even when he joined many years ago as a single man. Plus, we were separated for several months when Kate was born. So while not ideal, it's somewhat expected.

Even if I had zero complications and was pregnant with one, the official policy is that I would need to be back in the U.S. at 34 weeks. Due to the high risk issues with Kate, they wanted me back at 28 weeks, though I fought to stay in Dublin a bit longer since we were moving to a new house.

I'm definitely planning to deliver in the U.S., for a lot of reasons, and yes, I have wonderful help here. Everything is just so much easier in the U.S. ::sigh::

Elizabeth, exactly what I was thinking. I'm hesitant to talk to MED because of their power to make the decision. There is a very part-time practitioner at post, and unfortunately the new RMO doesn't arrive in Vienna (about an hour away) until late fall. Twenty weeks is kind of the number I've been throwing around, too. There are a few things that could be done if I went into labor before that, but I guess it's a risk I have to take. Plus, with my luck, and after all of this planning, I'll probably end up needing to be induced at 40 weeks :)